Eating meals in front of the television can lead to obesity, but keeping children away from noshing while viewing can be a challenge.

So Dr. Catherine Birken, a pediatrician and associate scientist at the Hospital for Sick Children Research Institute in Toronto, designed a study to see if a short and practical intervention at a child’s 3-year-old check-up could be successful at slashing screen time.

During the visit, parents received counseling and tips for reducing television viewing. Unfortunately, the intervention did not wind up reducing screen time by the children’s next visit, but it did help the families to eat fewer meals in front of the TV, according to research published in the journal Pediatrics. Although it wasn’t the main desired outcome of the research, Birken still considers it a significant achievement because evidence suggests that kids who eat in front of the TV aren’t as sensitive to food cues that signal fullness.

“There is strong experimental data that shows that reducing the number of meals in front of the TV may be the key to understanding screen time and obesity,” says Birken.

The research tracked 160 children in the TARGet Kids! primary care research network, which encompasses seven large pediatric and family medicine practices in Toronto. Those children whose parents were counseled by research assistants, either before or after their children were called in to see the doctor, reduced the number of meals they ate in front of the television by two meals per week. In general, the children were eating 1.5 meals a day accompanied by television chatter.

During the 10- to 15-minute counseling sessions, parents were encouraged to remove TVs from their kids’ bedrooms and to declare meal time a television-free zone, among other things. Children were also read a Berenstein Bears book called Too Much TV.

“Children are being bombarded by screens,” says Birken. “It may not be that surprising that a simple and short intervention in the primary care practice could not overcome the degree to which screen time is overwhelming in our society.”

As childhood obesity rates continue to rise, pediatricians are increasingly casting about for ways to reverse the trend. Incorporating public-health messages about healthy eating into children’s well visits is an obvious solution, but Birken says those efforts need to be refined. “This is telling us that this is not enough,” she says. “Young children come in to their primary care physician a huge number of times, but there’s less than ideal evidence about what physicians should be doing in terms of promoting healthy growth. We have to figure out what works and when it works.”

Further evaluation may look at who should counsel parents — doctors’ time is already at a premium, so the task could fall to nurses — and examine ways to broaden the message via day care centers and public health clinics. “If we can figure out what works and focus on a small number of key messages and repeat those messages in different settings, that’s probably what will make a difference,” says Birken. And with obesity rates, especially among children, continuing to rise, every intervention helps.